Provider Demographics
NPI:1649575069
Name:KNUROWSKI, CARRIE J (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:J
Last Name:KNUROWSKI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 CRESTVIEW DR
Mailing Address - Street 2:PO BOX 442
Mailing Address - City:BUTTE DES MORTS
Mailing Address - State:WI
Mailing Address - Zip Code:54927-9303
Mailing Address - Country:US
Mailing Address - Phone:920-420-8880
Mailing Address - Fax:
Practice Address - Street 1:617 W WATER ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WI
Practice Address - Zip Code:54968-9144
Practice Address - Country:US
Practice Address - Phone:920-295-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10151-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist